• Shun Watanabe, Tetsuya Kitagawa, Kazutoshi Tachibana, Hiroyuki Kurosawa, Kiyoshi Chiba, Joji Ito, Makoto Hibino, Masaki Taira, Takahiro Taguchi, and Masanori Nishimura.
• The committee of The Japanese Society for Cardiovascular Surgery Under-Forty, 2-26-9, Hongou, Bunkyo-ku, Tokyo, 113-0033, Japan. shunchan828@me.com.
• Gen Thorac Cardiovasc Surg. 2020 Jun 1; 68 (6): 557-564.

ObjectiveCurrently, no quantitative and objective method has been established for evaluating competencies in basic surgical techniques. The aim of this study was to develop a structured assessment tool for slip knotting and verify how well current board certification system discriminates the level of basic surgical skill.MethodsWe examined 171 cardiovascular surgical fellows using a novel assessment method for slip knotting that was developed by the committee of the Under-Forty of the Japanese Society of Cardiovascular Surgery. We compared the scores and examinees' surgical experience for validation. We analyzed the relationship between board certification and the scores.ResultsThe scores differentiated the general surgical board-certified surgeons from those without certification. Surgical experiences such as training years and number of operated cases and scores were correlated. Among the board-certified surgeons, the group with daily off-the-job training, or simulator-based skill training had a significantly higher mean score (67.4 ± 3.0 vs 55.4 ± 3.1, p = 0.008) and lower rate of poor scorers (7.1% vs 38.5%, p = 0.004). A multivariate analysis revealed that board certification did not predict high scores. Daily off-the-job training was the only independent predictor of high scores (odds ratio: 2.41, 95% confidence interval: 0.01-1.20, p = 0.014).ConclusionsThis novel quantitative and objective assessment tool for technical skill in slip knotting was found to be valid to examine the skill for slip knotting. In this study, current board certification discriminated the level of basic surgical skill. However, it could not distinguish extremely low scorers perfectly. Some board-certified surgeons showed poor technical competency, especially those without off-the-job training.

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